Cigarette smoking and mental health in England

We examined the link between poor mental health and smoking and identified which mental disorders are associated with the highest rates of smoking.
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  • Publishing date:
    12 January 2010


Cigarette smoking has a strong association with poor mental health. A third (33%) of people with a mental disorder were regular smokers, compared with just over a fifth (22%) of the English population as a whole.

Rates of smoking were even higher for some specific mental disorders

  • We assessed people for a range of different types of common mental disorders (CMD). The CMDs linked with the highest smoking rates were depression (37%) and phobias (37%).
  • Smoking rates among people with poor mental health were lowest for those with mixed anxiety and depression (29%).
  • Overall, people with probable psychosis (40%), alcohol dependence (46%) and illicit drug dependence (69%) were the most likely to be regular smokers.
  • 57% of people who had attempted suicide in the past year were smokers.

About 42% of all cigarettes smoked by the English general population are smoked by people with a mental disorder. Those with a CMD are the largest group, accounting for about a sixth of the population and about a third of all cigarettes smoked.


This research is secondary analysis of the Adult Psychiatric Morbidity Survey, a stratified probability sample survey of 7,400 people aged 16 and over living in private households in England. Interviews included detailed assessments for mental disorders and covered topics such as health risk behaviours like smoking and alcohol consumption.